Nir image-guided targeting

ABSTRACT

A method includes determining skin characteristics in a region of a patient. An in-treatment optical scan is performed on a region of a patient, wherein the in-treatment optical scan comprises a near infrared (NIR) energy source. A plurality of detected signals is detected from the optical scan. The skin characteristics are filtered out from the plurality of detected signals. Skeletal anatomy positioning associated with the region is determined from the plurality of signals that is filtered.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a divisional of U.S. patent application Ser. No.14/040,604, filed on Oct. 2, 2013, entitled “NIR Image-GuidedTargeting,” the disclosure of which is hereby incorporated by referencein its entirety, which claims priority to and the benefit under 35 U.S.C§119(e) of U.S. Provisional Patent Application No. 61/719,301, filed onOct. 26, 2012, entitled “NIR Image Guided Targeting,” and which alsoclaims priority to and the benefit under 35 U.S.C §119(e) of U.S.Provisional Patent Application No. 61/798,066, filed Mar. 15, 2013,entitled “Apparatus and Method for Real-Time Tracking of BonyStructures,” the disclosures of which are hereby incorporated byreference in their entirety.

This application is related to U.S. patent application Ser. No.14/040,609, filed on Sep. 27, 2013, entitled “Apparatus and Method forReal-Time Tracking of Bony Structures,” the disclosure of which ishereby incorporated by reference in its entirety.

BACKGROUND

Image-guided targeting has a growing role in a range of medicalprocedures. At its foundation, image-guidance involves the computercorrelation of near real time imagery with an historic three-dimensional(3D) volumetric data to determine the spatial location of patientanatomy. That is, image-guided targeting includes techniques andprocesses that are used to create images of the human body. Typicalexamples of 3D volumetric data for image-guided targeting includecomputed tomography (CT) or magnetic resonance imaging (MM).

The use of this image-guided targeting has been best described forprecise localization of patient bony anatomy in 3D space usingprojection x-rays or cone beam CT. The tacit assumption that underliesmost image-guidance is that skeletal anatomy can provide a reliablereference for nearby soft tissue. Sub-millimetric targeting accuracy ispossible with such techniques, thereby enabling even the most precisesurgical procedures to be performed under image-guidance.

The primary role of x-rays in image-guidance is to define the 3Dlocation of bony anatomy for image-correlation. Their relative capacityto penetrate skin is the cardinal feature of x-rays that enables them tobe used for imaging. In contrast, the kilovoltage energy x-rays used inimage-guidance are characterized by a much greater proclivity to bescattered off bone, and therefore a much greater likelihood of beingblocked from transmission through the tissue being imaged.

Although imaging with x-rays is robust, the challenge of using ionizingradiation burdens this approach because ionizing x-rays are potentiallyharmful to patients and the medical team. As such, current technologiesusing ionizing x-rays for image-guidance is rarely done on a continuousbasis. For example cone beam CT scans are generally only produced at thestart of a several minute to several hour procedure, while projectionx-rays used for image correlation are only generated every 20 to 60 sec.The infrequency of such “real time” imaging means that instantaneouspatient movement goes undetected, and will result in therapeuticinaccuracies.

What is needed is a truly real time imaging modality that can becorrelated to 3D patient anatomy.

SUMMARY

A method for treatment of a patient is disclosed. The method includesdetermining skin characteristics in a region of a patient. The methodincludes performing an in-treatment optical scan on a region of thepatient, wherein the in-treatment optical scan comprises a near infrared(NIR) energy source. The method includes detecting a plurality ofdetected signals from the optical scan. The method includes filteringout the skin characteristics from the plurality of detected signals. Themethod includes determining skeletal anatomy associated with the regionfrom the plurality of signals that is filtered.

In another embodiment, another method for treatment is disclosed. Themethod includes performing a base scan to obtain relative 3D (threedimensional) positioning of a target within a skeletal anatomy of apatient. The method also includes performing an in-treatment opticalscan on the patient to determine 3D positioning of the skeletal anatomywithin a treatment system, wherein the in-treatment optical scancomprises a near infrared (NIR) energy source. Further, the operation ofperforming an in-treatment optical scan includes detecting a pluralityof detected signals from the optical scan, and filtering out signalingcharacteristics for skin of the patient from the plurality of detectedsignals to obtain signals related to the skeletal anatomy and determinethe 3D positioning of the skeletal anatomy. The method also includesregistering the 3D positioning of the skeletal anatomy from thein-treatment optical scan and the 3D positioning of the skeletal anatomydetermined from the base scan to determine relative positioning of thetarget within the treatment system.

In another embodiment, a system for providing treatment is disclosed.The system includes a skin detector for determining skin characteristicsin a region of a patient. The system also includes an in-treatment nearinfrared (NIR) optical scanner for performing an in-treatment opticalscan on a region of the patient, wherein the in-treatment optical scancomprises a near infrared (NIR) energy source. The system includes atleast one detector for detecting a plurality of detected signals fromthe optical scan. The system includes a filter for filtering out theskin characteristics from the plurality of detected signals. The systemalso includes a modeling module for determining skeletal anatomyassociated with the region from the plurality of signals that isfiltered.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and form a part ofthis specification and in which like numerals depict like elements,illustrate embodiments of the present disclosure and, together with thedescription, serve to explain the principles of the disclosure.

FIG. 1 depicts a block diagram of an exemplary computer system suitablefor implementing the present methods, in accordance with one embodimentof the present disclosure.

FIG. 2A is a flow diagram illustrating a process for determiningskeletal anatomy information of a patient using NIR imaging data, inaccordance with one embodiment of the present disclosure.

FIG. 2B is a flow diagram illustrating a process for localizing theskeletal anatomy of an object or patient using NIR imaging data, inaccordance with one embodiment of the present disclosure.

FIG. 3A is a block diagram of a treatment system configured forperforming 3D patient modeling through NIR imaging, in accordance withone embodiment of the present disclosure.

FIG. 3B is a block diagram of a treatment system configured forproviding treatment of a patient including in-treatment patientlocalization determined through NIR imaging, in accordance with oneembodiment of the present disclosure.

FIG. 3C is an illustration of the application of an NIR imaging systemconfigured for providing 3D patient localization, in accordance with oneembodiment of the present disclosure.

DETAILED DESCRIPTION

Reference will now be made in detail to the various embodiments of thepresent disclosure, examples of which are illustrated in theaccompanying drawings. While described in conjunction with theseembodiments, it will be understood that they are not intended to limitthe disclosure to these embodiments. On the contrary, the disclosure isintended to cover alternatives, modifications and equivalents, which maybe included within the spirit and scope of the disclosure as defined bythe appended claims. Furthermore, in the following detailed descriptionof the present disclosure, numerous specific details are set forth inorder to provide a thorough understanding of the present disclosure.However, it will be understood that the present disclosure may bepracticed without these specific details. In other instances, well-knownmethods, procedures, components, and circuits have not been described indetail so as not to unnecessarily obscure aspects of the presentdisclosure.

Some portions of the detailed descriptions that follow are presented interms of procedures, logic blocks, processing, and other symbolicrepresentations of operations on data bits within a computer memory.These descriptions and representations are the means used by thoseskilled in the data processing arts to most effectively convey thesubstance of their work to others skilled in the art. In the presentapplication, a procedure, logic block, process, or the like, isconceived to be a self-consistent sequence of steps or instructionsleading to a desired result. The steps are those utilizing physicalmanipulations of physical quantities. Usually, although not necessarily,these quantities take the form of electrical or magnetic signals capableof being stored, transferred, combined, compared, and otherwisemanipulated in a computer system. It has proven convenient at times,principally for reasons of common usage, to refer to these signals astransactions, bits, values, elements, symbols, characters, samples,pixels, or the like.

It should be borne in mind, however, that all of these and similar termsare to be associated with the appropriate physical quantities and aremerely convenient labels applied to these quantities. Unlessspecifically stated otherwise as apparent from the followingdiscussions, it is appreciated that throughout the present disclosure,discussions utilizing terms such as “performing,” “varying,”“filtering,” “detecting,” “determining,” or the like, refer to actionsand processes of a computer system or similar electronic computingdevice or processor. The computer system or similar electronic computingdevice manipulates and transforms data represented as physical(electronic) quantities within the computer system memories, registersor other such information storage, transmission or display devices.

Flowcharts are provided of examples of computer-implemented methods forprocessing data according to embodiments of the present invention.Although specific steps are disclosed in the flowcharts, such steps areexemplary. That is, embodiments of the present invention are well-suitedto performing various other steps or variations of the steps recited inthe flowcharts.

Embodiments of the present invention described herein are discussedwithin the context of hardware-based components configured formonitoring and executing instructions. That is, embodiments of thepresent invention are implemented within hardware devices of amicro-architecture, and are configured for monitoring for critical stallconditions and performing appropriate clock-gating for purposes of powermanagement.

Other embodiments described herein may be discussed in the generalcontext of computer-executable instructions residing on some form ofcomputer-readable storage medium, such as program modules, executed byone or more computers or other devices. By way of example, and notlimitation, computer-readable storage media may comprise non-transitorycomputer storage media and communication media. Generally, programmodules include routines, programs, objects, components, datastructures, etc., that perform particular tasks or implement particularabstract data types. The functionality of the program modules may becombined or distributed as desired in various embodiments.

Computer storage media includes volatile and nonvolatile, removable andnon-removable media implemented in any method or technology for storageof information such as computer-readable instructions, data structures,program modules or other data. Computer storage media includes, but isnot limited to, random access memory (RAM), read only memory (ROM),electrically erasable programmable ROM (EEPROM), flash memory or othermemory technology, compact disk ROM (CD-ROM), digital versatile disks(DVDs) or other optical storage, magnetic cassettes, magnetic tape,magnetic disk storage or other magnetic storage devices, or any othermedium that can be used to store the desired information and that canaccessed to retrieve that information.

Communication media can embody computer-executable instructions, datastructures, and program modules, and includes any information deliverymedia. By way of example, and not limitation, communication mediaincludes wired media such as a wired network or direct-wired connection,and wireless media such as acoustic, radio frequency (RF), infrared andother wireless media. Combinations of any of the above can also beincluded within the scope of computer-readable media.

FIG. 1 is a block diagram of an example of a computing system 100capable of implementing embodiments of the present disclosure. Computingsystem 100 broadly represents any single or multi-processor computingdevice or system capable of executing computer-readable instructions.Examples of computing system 100 include, without limitation,workstations, laptops, client-side terminals, servers, distributedcomputing systems, handheld devices, or any other computing system ordevice. In its most basic configuration, computing system 100 mayinclude at least one processor 110 and a system memory 140.

Both the central processing unit (CPU) 110 and the graphics processingunit (GPU) 120 are coupled to memory 140. System memory 140 generallyrepresents any type or form of volatile or non-volatile storage deviceor medium capable of storing data and/or other computer-readableinstructions. Examples of system memory 140 include, without limitation,RAM, ROM, flash memory, or any other suitable memory device. In theexample of FIG. 1, memory 140 is a shared memory, whereby the memorystores instructions and data for both the CPU 110 and the GPU 120.Alternatively, there may be separate memories dedicated to the CPU 110and the GPU 120, respectively. The memory can include a frame buffer forstoring pixel data drives a display screen 130.

The system 100 includes a user interface 160 that, in oneimplementation, includes an on-screen cursor control device. The userinterface may include a keyboard, a mouse, and/or a touch screen device(a touchpad).

CPU 110 and/or GPU 120 generally represent any type or form ofprocessing unit capable of processing data or interpreting and executinginstructions. In certain embodiments, processors 110 and/or 120 mayreceive instructions from a software application or hardware module.These instructions may cause processors 110 and/or 120 to perform thefunctions of one or more of the example embodiments described and/orillustrated herein. For example, processors 110 and/or 120 may performand/or be a means for performing, either alone or in combination withother elements, one or more of the monitoring, determining, gating, anddetecting, or the like described herein. Processors 110 and/or 120 mayalso perform and/or be a means for performing any other steps, methods,or processes described and/or illustrated herein.

In some embodiments, the computer-readable medium containing a computerprogram may be loaded into computing system 100. All or a portion of thecomputer program stored on the computer-readable medium may then bestored in system memory 140 and/or various portions of storage devices.When executed by processors 110 and/or 120, a computer program loadedinto computing system 100 may cause processor 110 and/or 120 to performand/or be a means for performing the functions of the exampleembodiments described and/or illustrated herein. Additionally oralternatively, the example embodiments described and/or illustratedherein may be implemented in firmware and/or hardware.

In embodiments of the present invention, near infrared light is used forimage-guided targeting. Near infrared (NIR) energy (e.g., light) isdefined as a spectrum of electromagnetic energy ranging from about 740nm to 1000 nm. At these energies, photons have some capacity to passthrough modest amount of tissue before being completely scattered.Different tissues result in a range of scattering patterns, with onebeing opaque to NIR penetration. In this sense, NIR has commonscattering properties with ionizing x-rays. Embodiments of the presentinvention use these properties to localize in 3D space the position ofthe skeletal anatomy, thereby obviating the need for x-rays.

Other embodiments of the present invention provide for skincharacterization, 3D localization of skeletal anatomy of an objectand/or patient, and 3D localization of soft tissue targets of an objectand/or patient. In particular, in one embodiment, the use of a highenergy, collimated laser or similar light source (e.g., NIR, etc.) isused to characterize a patient's skin characteristics. The energy sourceis of sufficient strength to penetrate but not to harm the patient. Inanother embodiment, the use of NIR is used to visualize the patient'sskeletal anatomy using IR reflectance and mapping.

FIG. 2A is a flow diagram 200A illustrating a process for determiningskeletal anatomy information of a patient using NIR imaging data, inaccordance with one embodiment of the present disclosure. Some or all ofthe operations in flow diagram 200A are performed within a computersystem including a processor and memory coupled to the processor andhaving stored therein instructions that, if executed by the computersystem cause the system to execute a method for determining skeletalanatomy information of a patient using NIR imaging data. In stillanother embodiment, instructions for performing a method are stored on anon-transitory computer-readable storage medium havingcomputer-executable instructions for causing a computer system toperform a method for determining skeletal anatomy information of apatient using NIR imaging data. The method outlined in flow diagram 200Ais implementable by one or more of the components of the computer system100 and systems 300A and 300B of FIGS. 3A and 3B, respectively.

At 210, the method includes determining skin characteristics of anobject or patient. More specifically, the skin characteristics aredetermined for a region of a patient. For instance, skin characteristicsare determined for a skull region. In other examples, skincharacteristics are determined for a region located on a torso of thepatient. The region is generally near a surgical target located on orwithin the patient.

In one embodiment, the skin characteristics are determined by performingan NIR optical scan. For instance, in one embodiment, the use of NIR forthe imaging and mapping of a patient's skeletal anatomy involves thecharacterization of the amount of signal that is absorbed by thepatient's skin. This is achieved by using a high intensity laser with aknown wavelength and intensity. As such, the use of NIR or othersuitable signaling allows for a means of characterizing a patient'sexternal skin characteristics. Also, the use of NIR allows for the meansto illuminate the skeletal anatomy in real-time.

For example, when determining skin characteristics, the method includesperforming another optical scan on the region of the patient usinganother source emitting NIR energy. In one embodiment, the source emitsenergy of varying intensity for a given frequency. In another embodimentthe source emits energy of varying frequency. In still anotherembodiment, the source emits energy of varying intensity and frequency(e.g., wavelength). The method further includes determining signalingcharacteristics for skin related to at least one of skin reflectancecharacteristics, skin transmittive characteristics, and a skinfluorescence characteristics, such that the signaling characteristicsare filterable from the plurality of detected signals. As such, in oneembodiment, the data collected provides a reflectance “spectral cube”which could be assessed for maximal reflectance of underlying anatomy(e.g., through filtering).

In still another embodiment, a higher energy NIR source could be used toelicit excitation of skeletal anatomy and collection of the reflectancesignal directly for determining skeletal information (e.g.,positioning), in another embodiment. Specifically, the method includesperforming another optical scan on the patient across varyingfrequencies and intensity using another NIR energy source. An optimalfrequency and intensity combination is determined that optimallyilluminates the skeletal anatomy with minimal skin signalingcharacteristics. As such, the skin characteristics need not be filtered,and as such, the in-treatment optical scan is performed on the patientusing the optimal frequency and intensity combination, such thatfiltering of the skin characteristics are unnecessary.

In another embodiment, the skin characteristics are determined usingtraditional methods, such as, those performed with using computedtomography (CT) or magnetic resonance imaging (MRI). While truecharacterization of an individual patient's skin can be carried out byextracting a histological sample of the tissue, it is obviously notconducive for real world clinical treatments in radiation therapy. Assuch, embodiments of the present invention provide for non-invasivespectroscopic methods to perform skin characterization, to include thefollowing techniques, such as, diffuse reflectance, fluorescence, X-rayfluorescence (XRF) Fourier Transform IR (FTIR), among others.

At 220, the method includes performing an in-treatment optical scan on aregion of the patient. The optical scan is performed using an NIR energysource or optical scanner. For example, post skin characterization, insitu visualization of the skeletal anatomy is performed using abroadband, NIR source, and appropriate sensor, as will be described inrelation to FIGS. 3B and 3C. The in-treatment optical scan processincludes detecting a plurality of detected signals from the optical scanat 230. For instance, the detectors are configurable to receive signalsthat re reflected off the patient, transmittive signals that aretransmitted through the patient, and fluorescence signals that areemitted from the patient.

Additionally, at 240, the method includes filtering out skincharacteristics for the plurality of detected signals. That is, the datacollected at the plurality of detectors is then filtered to remove thecontribution from the individual patient's skin that is derived from thecharacterization step performed at 210. For instance, these calculationscan all be carried out on a commercially available GPU based processorproviding the capability of real time visualization of skeletal anatomy.

At 250, the method includes determining skeletal anatomy informationassociated with the region from the plurality of signals that isfiltered. In particular, skin characterization increases the accuracy ofradiation treatment. That is, the plurality of detected signals can bede-convoluted to remove the contribution from the skin. As such, theunderlying skeletal anatomy is obtained.

FIG. 2B is a flow diagram 200B illustrating a process for localizing theskeletal anatomy of an object or patient using NIR imaging data, inaccordance with one embodiment of the present disclosure. Some or all ofthe operations in flow diagram 200B are performed within a computersystem including a processor and memory coupled to the processor andhaving stored therein instructions that, if executed by the computersystem cause the system to execute a method for localizing the skeletalanatomy of an object or patient using NIR imaging data. In still anotherembodiment, instructions for performing a method are stored on anon-transitory computer-readable storage medium havingcomputer-executable instructions for causing a computer system toperform a method for localizing the skeletal anatomy of an object orpatient using NIR imaging data. The method outlined in flow diagram 200Bis implementable by one or more of the components of the computer system100 and systems 300A and 300B of FIGS. 3A and 3B, respectively.

At 260, the method includes performing a base scan to obtain relative 3Dpositioning of a surgical target within a skeletal anatomy of an objector patient. For instance, the base scan includes traditional methodologyfor performing a planning CT, or MRI. The information obtained from thebase scan includes, in part skin characterization information, andskeletal anatomy information.

At 265, the method includes performing an in-treatment optical scan onthe patient to determine 3D positioning of the skeletal anatomy within atreatment system or environment. For instance, the method includesilluminating a patient's anatomy with a high intensity NIR source.

At 270, the method includes detecting a plurality of detected signalsderived from the optical scan. For instance, the method includesmeasuring or detecting transmitted, reflected, and fluorescent energywith one or more precisely calibrated sensors/cameras.

At 275, the method includes filtering out signaling characteristics forskin of the patient from the plurality of detected signals to obtainsignals related to the skeletal anatomy. In that manner, the 3Dpositioning of the skeletal anatomy within the treatment system can alsobe determined. For instance, the method includes using intensity oflight and time of flight analysis of the recorded and filtered signal totriangulate and deduce the precise 3D spatial location of the object(e.g., skeletal) surface.

At 280, the method includes co-registering the skeletal model to thereference patient CT or MM dataset for purposes of accurate patientpositioning. Specifically, the method includes registering the 3Dpositioning of the skeletal anatomy obtained from the in-treatmentoptical scan and the 3D positioning of the skeletal anatomy determinedfrom the base scan to determine relative positioning of the surgicaltarget within the treatment system. That is, image-to-image correlationis performed, such that the image of the skeletal anatomy is correlatedwith a prior scan (e.g., CT, MT, or MRI) scan generated through the sameobject or patient anatomy. The 3D images of the skeletal anatomy scansare compared to determine a closest fit of data. For instance, a leastsquared comparison process will find the closest fit between the NIRimage of anatomy and the previously obtained CT/MRI volumetric data.Thereafter, extrapolation may be performed to determine the 3D spatiallocation of the surgical target within the object and/or patient. Assuch, the 3D spatial location of the surgical target is obtained withinthe treatment system through extrapolation.

Once localization of the patient within the treatment system is known,the method includes broadly positioning skeletal and/or human anatomysuch that radiation is properly directed to the surgical target. Morespecifically, after localization of the patient, if it is found that thesurgical target is misaligned with treatment beam radiation, anadjustment is made to the relative positioning between human anatomy andthe treatment beam radiation is performed. In that manner, properalignment of the surgical target with the treatment beam radiation isachieved.

More specifically, once the location of the surgical target is known inrelation to the skeletal anatomy, precisely calibrated cameras andappropriate software can then be used to guide stereotactic procedures.That is, the surgical target is then exposed to the treatment beamradiation from the treatment system. Because no ionizing radiation isbeing used during the localization process, the process of determiningskeletal and therefore target position can be continuous, in embodimentsof the present invention. That is, the in-treatment optical scan can beperformed on the patient on a periodic basis under various medicalapplications to provide consistent and accurate positioning of patientsin relation to the treatment system (e.g., treatment beam radiation)during diagnostic imaging and the positioning of invasive or minimallyinvasive surgical tools. In one embodiment, the scans are performed 1-5times per second. In another embodiment, the scans are performed between20-30 scans per second. Even higher rates are achievable, in otherembodiments. In summary, the base scan provides localization of thesurgical target within the skeletal anatomy. The in-treatment opticalscan provides location of the skeletal anatomy within the treatmentsystem. By registering the skeletal anatomy derived from the base scanwith the skeletal anatomy derived from the in-treatment optical scan,localization of the surgical target within the treatment system isobtained. In that manner, accurate positioning of the patient isachieved for proper treatment.

As a result, with continuous patient localization, the method includesupdating registration of the 3D positioning of said skeletal anatomyobtained from the in-treatment optical scan and the 3D positioning ofthe skeletal anatomy determined from the base scan based on a currentin-treatment optical scan to determine current relative positioning ofthe surgical target within the treatment system. As such, the methodalso includes aligning the target and the treatment beam radiation basedon the current relative positioning to expose the target to thetreatment beam radiation.

In still other embodiments, the broad positioning of the patient isperformed within the context of any diagnostic system or any automatedsystem requiring accurate positioning of the patient within that system,and possibly wherein no ionizing radiation is used for treatment. Forinstance, the patient may be undergoing a routine diagnostic MRI, CT orPET scan, such as, those used for planning. As such, once the locationof the patient or a region of the patient is known within the diagnosticsystem, the relative positioning of the patient and the diagnosticsystem may be adjusted to improve diagnostic testing. For example, thepatient may be repositioned within the diagnostic system. That is, thepatient may be repositioned within the MM, CT, or PET scanning apparatuswith the aid of the NIR positioning device that uses NIR imaging todetermine localization of the patient within the diagnostic system. Inother applications, the patient may be undergoing a surgical operationwith the use of systems for performing automated surgical techniques orguidance systems used for aiding a surgeon during the operation (e.g.,guiding the placement of a knife when making an incision on a surgicaltarget). As such, the NIR positioning device using NIR imaging is usedto properly position and align the patient within the system foraccurate treatment. Also, the NIR positioning device is used to provideguidance during a surgical procedure by properly positioning thesurgical target within the surgical environment, identifying thesurgical target, and verifying the proper location of the surgicaltarget, such that the information may be used to help guide the hand ofthe surgeon during the surgical procedure.

The accuracy and sensitivity of the various approaches presented inembodiments of the present invention rely may rely on the strength ofthe reflectance signal received from the skeletal anatomy of interestand on the sensitivity of the detection sensor. In one embodiment, it isadvantageous to use a sensor with high spectral and spatial resolutionin the NIR spectrum.

FIG. 3A is a block diagram of a treatment system 300A configured forperforming 3D patient modeling through NIR imaging, in accordance withone embodiment of the present disclosure. For instance, treatment system300A is configurable to implement the method of FIG. 2A, and portions ofFIG. 2B to provide real-time patient modeling and localization during anin-treatment procedure, in one embodiment. That is, the treatment system300A is implementable to provide patient modeling and localization inorder to provide accurate beam placement on a surgical target within askeletal anatomy of a patient.

Treatment system 300A includes a skin detector 325 configured fordetermining skin characteristics of a patient. As previously described,the skin detector may include a traditional CT, MT, or MRI scanningsystem to determine skin characteristics. In another embodiment, theskin detector 325 may include an NIR optical scanner used to determinecustomized data related to skin characteristics of a particular patient.For example, signaling related to the skin characteristics may bedeterminable, and later filtered out to obtain signaling informationrelated to the skeletal anatomy, when the patient is illuminated withNIR energy. For instance, skin detector 325 may perform operation 210 inFIG. 2A, and operation 260 in FIG. 2B, in embodiments.

Treatment system 300A also includes an in-treatment NIR optical scanner310 configured for performing an in-treatment optical scan on a regionof the patient. Information obtained from the optical scanner 310 isused to determine 3D positioning of the skeletal anatomy within atreatment system. For instance, the NIR optical scanner 310 is used toperform operation 220 of FIG. 2A, and 265 of FIG. 2B.

Treatment system 300A also includes one or more detectors 330 configuredfor measuring and/or detecting one or more of reflected signals,transmitted signals, or fluorescent signals excited and/or derived fromthe NIR optical scanner 310 after interaction with the patient. Forinstance, detector 330 is configured to perform operations 230 of FIG.2A, and 270 of FIG. 2B. Treatment system 300A also includes a filter 335for filtering out skin characteristics from the plurality of detectedsignals. For instance, filter 335 is configured to perform operations240 of FIG. 2A, and 275 of FIG. 2B.

Treatment system 300A also includes a modeling module 340 configured fordetermining skeletal anatomy of the patient from the filtered anddetected signals. In particular, the modeling module 340 models a regionof the patient, wherein the region is near to the surgical target. Assuch, a model of the skeletal anatomy in the region is created by themodeling module 340.

FIG. 3B is a block diagram of a treatment system 300B configured forproviding treatment of a patient including in-treatment patientlocalization determined through NIR imaging, in accordance with oneembodiment of the present disclosure. For instance, treatment system300B is configurable to implement the method of FIG. 2B, and portions ofFIG. 2A to provide real-time patient modeling and localization during anin-treatment procedure, in one embodiment.

As shown, treatment system 300B includes a base scanner 305 configuredfor performing a base scan to obtain relative 3D positioning of asurgical target within a skeletal anatomy of an object or patient. Forinstance, base scanner 305 is configured to determine skincharacteristics at 210 of FIG. 2A, in one embodiment. Also, base scanner305 is configured to perform the operation at 260 of FIG. 2B, in oneembodiment.

System 300B also includes an in-treatment NIR optical scanner 310configured to determine 3D positioning of the skeletal anatomy within atreatment system or environment. For instance, scanner 310 is configuredto perform an in-treatment optical scan, such as, those operationsoutlined in 220 of FIG. 2A, and the operations outlined in 265 of FIG.2B. In that manner, reflected, transmitted, and fluorescent signals aredetectable at one or more detectors (not shown) and used for determininga model of the patient. In one embodiment, the skin characteristics arefiltered using a filter (not shown) out from the detected signals toobtain a skeletal model of the patient using a modeling module (notshown).

System 300B also includes a registration model 315 that is configuredfor registering the 3D positioning of the skeletal anatomy obtained fromthe in-treatment optical scan and the 3D positioning of the skeletalanatomy determined from the base scan to determine relative positioningof the surgical target within the treatment system. System 300B alsoincludes a treatment beam radiator 320 that is configured for exposingthe surgical target to a treatment beam radiation originating from thetreatment system.

FIG. 3C is an illustration of the application of an NIR imaging system300C configured for providing 3D patient localization, in accordancewith one embodiment of the present disclosure. For instance, NIR imagingsystem 300C is implementable to provide pre-treatment optical scanningused for skin characterization, and in-treatment optical scanning usedfor determining both in-treatment patient modeling and localization.

In particular, system 300C includes an NIR apparatus as the NIR opticalscanner 370 for emitting energy 375 onto an object 350 (e.g., patient).In some implementations, NIR instrumentation for NIR spectroscopyincludes a source, a detector, and a dispersive element (e.g., prism ordiffraction grating). This allows intensity at different wavelengths tobe recorded and sampled either in reflection or transmission mode. Anysource for producing NIR radiation may be used.

Detectors 360A-C are sensitive to the range of wavelengths used, andinclude charge-coupled device image sensors, complimentarymetal-oxide-semiconductor (CMOS) based sensors, phosphorous basedIR-visible converters, InGaAs photodiodes, etc., taken alone or incombination. These sensors are used to record NIR spectra obtained fromreflected, fluorescent, and/or transmitted energy originating from thescanner 370. As an example, detector 360A is used to detect reflectedwavelengths or energy, detector 360B is used to detect transmittedwavelengths or energy, and detector 360C is used to detect florescentenergy. In embodiments, one or more detectors are use, wherein eachdetector is configured to detect one or more of the reflected,fluorescent, and/or transmitted energy.

Thus, according to embodiments of the present disclosure, systems andmethods are described providing for patient modeling and localizationusing NIR imaging.

While the foregoing disclosure sets forth various embodiments usingspecific block diagrams, flowcharts, and examples, each block diagramcomponent, flowchart step, operation, and/or component described and/orillustrated herein may be implemented, individually and/or collectively,using a wide range of hardware, software, or firmware (or anycombination thereof) configurations. In addition, any disclosure ofcomponents contained within other components should be considered asexamples because many other architectures can be implemented to achievethe same functionality.

The process parameters and sequence of steps described and/orillustrated herein are given by way of example only and can be varied asdesired. For example, while the steps illustrated and/or describedherein may be shown or discussed in a particular order, these steps donot necessarily need to be performed in the order illustrated ordiscussed. The various example methods described and/or illustratedherein may also omit one or more of the steps described or illustratedherein or include additional steps in addition to those disclosed.

While various embodiments have been described and/or illustrated hereinin the context of fully functional computing systems, one or more ofthese example embodiments may be distributed as a program product in avariety of forms, regardless of the particular type of computer-readablemedia used to actually carry out the distribution. The embodimentsdisclosed herein may also be implemented using software modules thatperform certain tasks. These software modules may include script, batch,or other executable files that may be stored on a computer-readablestorage medium or in a computing system. These software modules mayconfigure a computing system to perform one or more of the exampleembodiments disclosed herein. One or more of the software modulesdisclosed herein may be implemented in a cloud computing environment.Cloud computing environments may provide various services andapplications via the Internet. These cloud-based services (e.g.,software as a service, platform as a service, infrastructure as aservice, etc.) may be accessible through a Web browser or other remoteinterface. Various functions described herein may be provided through aremote desktop environment or any other cloud-based computingenvironment.

The foregoing description, for purpose of explanation, has beendescribed with reference to specific embodiments. However, theillustrative discussions above are not intended to be exhaustive or tolimit the invention to the precise forms disclosed. Many modificationsand variations are possible in view of the above teachings. Theembodiments were chosen and described in order to best explain theprinciples of the invention and its practical applications, to therebyenable others skilled in the art to best utilize the invention andvarious embodiments with various modifications as may be suited to theparticular use contemplated.

Embodiments according to the present disclosure are thus described.While the present disclosure has been described in particularembodiments, it should be appreciated that the disclosure should not beconstrued as limited by such embodiments.

What is claimed:
 1. A method for obtaining anatomical information,comprising: performing an optical scan on a region of a patient, whereinsaid optical scan comprises a near infrared (NIR) energy source;detecting a plurality of detected signals from said optical scan;filtering out skin characteristics from said plurality of detectedsignals; and determining skeletal anatomy associated with said regionfrom said plurality of signals that is filtered.
 2. The method of claim1, further comprising determining skin characteristics for skin, whereinsaid determining skin characteristics for skin comprises: performing acomputed tomography (CT) scan to determine at least one of skinreflectance characteristics, skin transmittive characteristics, and skinfluorescence characteristics.
 3. The method of claim 1, furthercomprising determining skin characteristics for skin, wherein saiddetermining skin characteristics for skin comprises: performing amagnetic resonance imaging (MRI) scan to determine at least one of skinreflectance characteristics, skin transmittive characteristics, and askin fluorescence characteristics.
 4. The method of claim 1, furthercomprising determining skin characteristics for skin, wherein saiddetermining skin characteristics for skin comprises: performing anotheroptical scan on said region of said patient, wherein said anotheroptical scan comprises another source emitting NIR energy; varyingintensity of said NIR energy for a given frequency; and determiningsignaling characteristics for skin related to at least one of skinreflectance characteristics, skin transmittive characteristics, and askin fluorescence characteristics, such that said signalingcharacteristics are filterable from said plurality of detected signals.5. The method of claim 1, further comprising determining skincharacteristics for skin, wherein said determining skin characteristicsfor skin comprises: performing another optical scan on said region ofsaid patient, wherein said another optical scan comprises another sourceemitting NIR energy; varying frequency of said NIR energy; determiningsignaling characteristics for skin related to at least one of skinreflectance characteristics, skin transmittive characteristics, and askin fluorescence characteristics, such that said signalingcharacteristics are filterable from said plurality of detected signals.6. The method of claim 1, further comprising determining skincharacteristics for skin, wherein said determining skin characteristicsfor skin comprises: performing another optical scan using another sourceemitting NIR energy on said region of said patient, wherein said opticalscan is performed over varying frequencies and intensities; anddetermining signaling characteristics for skin related to at least oneof skin reflectance characteristics, skin transmittive characteristics,and a skin fluorescence characteristics, such that said signalingcharacteristics are filterable from said plurality of detected signals.7. The method of claim 1, further comprising determining skincharacteristics for skin, wherein said determining skin characteristicsfor skin comprises: performing another optical scan on said region ofsaid patient across varying frequencies and intensity of another NIRenergy source; determining an optimal frequency and intensitycombination that optimally illuminates said skeletal anatomy withminimal skin signaling characteristics; and performing said optical scanon said region of a patient using said optimal frequency and intensitycombination.
 8. A system, comprising: a skin detector for determiningskin characteristics in a region of a patient; an in-treatment nearinfrared (NIR) optical scanner for performing an optical scan on aregion of said patient, wherein said optical scan comprises a nearinfrared (NIR) energy source; at least one detector for detecting aplurality of detected signals from said optical scan; a filter forfiltering out said skin characteristics from said plurality of detectedsignals; and a modeling module for determining skeletal anatomyassociated with said region from said plurality of signals that isfiltered.
 9. The system of claim 8, wherein said skin detector isselected from the group consisting of: a computed tomography (CT)scanner, and a magnetic resonance imaging (MRI) scanner.
 10. The systemof claim 8, wherein said skin detector comprises: another NIR scannerconfigured for performing another optical scan on said region of saidpatient, wherein said another optical scan is performed over varyingfrequencies and intensities, wherein said NIR scanner is used fordetermining signaling characteristics for skin related to at least oneof skin reflectance characteristics, skin transmittive characteristics,and a skin fluorescence characteristics, such that said signalingcharacteristics are filterable from said plurality of detected signals.11. The system of claim 8, wherein said skin detector comprises: anotherNIR scanner configured for performing another optical scan on saidregion of said patient across varying frequencies and intensity ofanother NIR energy source; and a frequency and intensity selector fordetermining an optimal frequency and intensity combination thatoptimally illuminates said skeletal anatomy with minimal skin signalingcharacteristics, wherein said near infrared (NIR) optical emitter emitsNIR energy on said region of said patient using said optimal frequencyand intensity combination.
 12. The system of claim 8, furthercomprising: a base scanner configured for performing a base scan toobtain relative 3D positioning of a target within a skeletal anatomy ofa patient; wherein said in-treatment NIR optical scanner is configuredto determine 3D positioning of said skeletal anatomy within a treatmentsystem; a registration module configured for registering said 3Dpositioning of said skeletal anatomy from said in-treatment optical scanand said 3D positioning of said skeletal anatomy determined from saidbase scan to determine relative positioning of said target within saidtreatment system; and a treatment beam radiator configured for exposingsaid target to treatment beam radiation from said treatment system.